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LIBRARY OF CONGRESS. 

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UNITED STATES OF AMERICA. 













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CONSUMPTION 



AND 



HOW TO PREVENT IT 



BY 



J" 



THOMAS J. MAYS, M. D. 



MEMBER OF THE LUZERNE COUNTY MEDICAL SOCIETY ; MEMBER OF THE PENN- 

^SVLVANIA MEDICAL SOCIETY ; MEMBER OF THE AMERICAN MEDICAL 

ASSOCIATION ; AUTHOR OF " ON THE. THERAPEUTIC 

' FORCES," ETC. 













NEW YORK 


P. 


PUTNAM'S SONS 




182 FIFTH AVENUE 




1879 









COPYRIGHT BY 

G. P. PUTNAM'S SONS. 
1879 



CONTENTS 



Introduction .... 
General Physiological Principles . 
General Nature of Consumption 
Influence of Foods .... 
Influence of Air .... 
Influence of Soils .... 
Influence of Clothing 
Influence of Light .... 
Influence of Physical Exercises 
Influence of Disease, etc. 
Influence of Digestion 
Influence of Infant Diet .... 
Influence of Cod-Liver Oil, Fat, Butter and 
Alcohol 



5 

10 

15 

22 

26 

36 

46 

54 
61 
69 

74 
81 

85 



Conclusion 89 



CONSUMPTION. 



CHAPTER I. 



INTRODUCTION. 



It is a patent fact that consumption is more de- 
structive to human life than any other disease. 
Its doleful and seemingly endless march sweeps 
many thousands of victims to an untimely grave, 
yet, the perfect indifference and complacency with 
which we view its enormity is a surprising spectacle. 
The sudden ravages of yellow fever strike mortal 
terror into every human breast, and for the time 
being become the absorbing theme of the pulpit, 
the press, and the fireside ; while millions upon mil- 
lions are magnanimously poured out for the purpose 
of alleviating and assuaging the misery of the suffer- 
ers. But when we come to realize the fact that on 
the whole the fatality of this disease is far less than 
that of consumption, it is indeed astonishing to find 
that the latter scarcely receives a passing comment, 
much less serious notice, except from some wary 

5 



6 Consumption. 

philanthropic sanitarian, who " cries out in the wil- 
derness." For the number of deaths from yellow 
fever in this country for the year 1878 (which will 
hardly reach 20,000), when compared with the mor- 
tality of consumption, which amounted to 69,896 
deaths in 1870, (and we have no reason to believe 
that the number is any less, rather more, this year), 
will show that about five times more individuals died 
of consumption than of yellow fever, notwithstand- 
ing that this was a very prolific year for the latter 
disease. 

It is a very hard matter, perhaps, to account for 
the extreme apathy which is manifested towards the 
prevention of consumption, u'nless it is ignorance of 
the true nature and character of the disease, and the 
widespread and deeply rooted belief that, sooner or 
later, it is fatal to every person who is tainted by its 
influence. Individuals, and indeed whole families, 
are firmly imbued with the conviction that they are 
doomed to become the victims of this terrible de- 
stroyer, then give up all hope and needlessly perish. 
Is this not suicidal ? Physicians, at least up to a 
very recent period, have in a great measure been 
unable to lessen the mortality of this formidable 
disease, which to a certain extent, assists in giving 
color to the notion that all efforts to mitigate it are 
futile. Medical science, however, is not so much at 
fault here as are those who labor under the effects 



Introduction. 7 

of the disease. Very often it is by expecting the 
impossible from medicine that causes a decline of 
faith in its efficacy ; and in that stage of consump- 
tion in which valuable remedial aid can be rendered, 
the victim fails to take advantage of his opportunity 
and thus imperils his life to a great extent. He is 
thus letting the golden moment slip by, and when 
he is aroused to a true sense of his dangerous situa- 
tion he may be beyond the limit of human aid. 

That consumption is preventable is a reasonable 
as well as a practicable idea, and in spite of the ig- 
norance which is displayed by the popular mind on 
this subject, there exists a growing feeling that such 
an end can be accomplished by proper precautionary 
measures. As evidence of this I can say that I have 
received many assurances from members of different 
consumptive families, who believe that they have 
been instrumental in preventing it in themselves as 
well as in their offspring. And I have no reason to 
doubt the perfect truth of this. On this subject an 
illustrious lay writer * has recently expressed his 
views on the preventability of consumption, under 
the title of Thin Living and Thick Dying, in the fol- 
lowing words : " If any reader of this article will 
take General Walker's Statistical Atlas, based on 
the results of the Ninth Census, and turn to the 

1 *Dr. Holland in Scribner's Monthly \ July, 1878, p. 430. 



8 Consumption. 

page which represents the mortality from consump. 
tion, he will be startled to see that, over an immense 
area of the Northern American Territory, one-fifth 
of all the deaths that occur are in consequence of 
this fell disease. The whole of Maine and New 
Hampshire, the most of Vermont, Massachusetts, 
and Connecticut, and all of Northern New York, 
show that two thousand out of every ten thousand 
who die, owe their death to consumption ; while, in 
very much larger areas about the great lakes, the 
deaths from this disease range from one thousand 
four hundred to two thousand in every ten thousand. 
If Asiatic cholera were to claim in these unfortunate 
regions, in a single year, as many victims as com 
sumption does, it would be regarded as a terrible epL 
demic, — perhaps, as an awful visitation from heaven. 
" It would be a great benefit to New England, and 
all the regions associated with her in this sad scourge, 
to know how far the dangers of their inhospitable 
climate can be avoided by a change in diet and reg- 
imen. Our own opinion is that consumption can 
be driven from New England in three generations. 
* * * If our physicians could only be paid for 
preventing disease, and could be permitted to pre- 
scribe for each family its way of living, there would 
be but little difficulty in routing from its stronghold 
that most fatal and persistent enemy of human life, 
which we call consumption. " 



Introduction. 9 

Leaving it an open question as to whether 
knowledge is the panacea for all the evils to which 
flesh is heir, one thing is firmly established in my 
mind, and that is that before the people are in a 
condition to escape and avoid consumption, they 
must first possess a general knowledge of the laws 
which produce, maintain and prevent this disease, 
and hence these pages will be devoted to a consid- 
eration of these laws. 



CHAPTER II. 

GENERAL PHYSIOLOGICAL PRINCIPLES. 

To obtain a clear conception of the means and 
methods which are essential for the prevention of 
consumption, it is necessary first to study and be- 
come acquainted with some of the most important 
principles of action which pervade the body in 
health, as well as with those in the disease which 
we have under discussion ; hence the present chap- 
ter will briefly treat of the general laws of health, 
and the succeeding one of that morbid condition 
which is peculiar to consumption. 



It is now a well established fact in physiology 
that in many respects the animal body bears a strik- 
ing resemblance to any ordinary machine. It con- 
tains a material structure, the sole aim of which is 
the performance of work : so a machine is likewise 
composed of matter arranged in the most advan- 
tageous manner for the same purpose. The only 
dissimilarity between the two is that the body re- 



' General Physiological Principles. n 

pairs its own structure, while a machine does not 
and cannot. This analogy becomes clearer, per- 
haps, by using a particular machine as an.illustraT 
tion. The steam-engine, for example, is chiefly 
composed of iron, with all its parts arranged in such 
a manner that it can transform the greatest possible 
quantity of molecular motion into mechanical mo- 
tion. The intense chemical affinity which exists 
between the molecules of carbon and hydrogen in 
the coal on the one hand, and those of atmospheric 
oxygen on the other, causes them to clash together 
with tremendous force, and in this way they gener- 
ate a certain amount of heat-motion, which is trans- 
mitted to the molecules of water in the boiler. 
These expand and tend to occupy more space, and 
by so expanding they produce pressure on the 
piston which is attached to the fly wheel and set 
the latter in motion. Thus by the aid of machinery, 
we see that it is possible to derive mechanical mo- 
tion from molecular motion. 

The structure of the animal frame consists of 
nerves, muscles, blood, blood-vessels, bone, cartilage, 
etc. The nerves, muscles, blood, etc., are princi- 
pally composed of albuminous or nitrogenous prin- 
ciples, while bone, cartilage, etc., are made up chiefly 
of inorganic principles, such as lime, soda, etc. Fat 
and water also enter very largely into the composi- 
tion of the body, and although the former is one of 



12 Consumption. 

its essential elements, it can hardly be called any- 
thing else than a deposit. This then comprises the 
structure of the bodily machine, but to set this ma- 
chine in motion, another factor is requisite, and that 
is force. This is mainly supplied in the form of 
substances altogether different and distinct from the 
albuminous and inorganic substances, which are 
called non-nitrogenous, because they contain little 
or no nitrogen. Between those substances which 
supply material for the structure of the body, and 
those which supply its moving power, there is then 
a marked chemical difference. The former chiefly 
contain nitrogen, except those of inorganic origin, 
while the latter contain mostly carbon and hydro- 
gen. Now all these essential elements are con- 
veyed to the body through the food, and we shall in 
the future know them under the name of nitro- 
genous, non-nitrogenous and inorganic foods. 

Now the muscular system, which is the most ex- 
tensive structure in the body, is, like the water in 
the steam boiler, capable of changing the molecular 
motion resulting from the combustion of the carbon 
and hydrogen of the food on the one hand, and the 
oxygen of the air on the other, into massive motion. 
As, for example, if a muscle contracts, one end of 
which is inserted into the upper arm and the other 
into the forearm, it at once changes the relative 
position of the bones, and thus bends the arm at 



Ge?ieral Physiological Principles. 13 

the elbow, or, in other words, produces massive or 
mechanical motion. The muscle in contracting per- 
forms work, and hence must expend force, and this 
force chiefly emanates from the oxidation of the 
non-nitrogenous foods. The bones then bear the 
same relation to the body as does the piston to the 
engine, mere levers by which the muscles are able 
to change the position of the body, or of parts of 
it. Not all the muscles, however, are inserted into 
bones, and used for the purpose of rpoving them, 
but the blood-vessels, the b6wefe, and many other 
hollow organs, are invested with muscular walls, for 
the purpose of diminishing and enlarging their cali- 
bre. The nervous system, which is the most im- 
portant structure of the body, is composed of gang- 
lions or cells, and threads or fibres, and it is designed 
to regulate and control every other structure in the 
body. The nerve fibres, which pervade every part 
of the body, constitute a system of telegraph wires, 
through which the brain and other important nerve 
centres are brought into intimate relation with the 
whole body. Now the nervous system bears the 
same relation to the muscles as does the lever of the 
engine to the force which is latent in the boiler, or 
that of the trigger to the force of the powder in 
the gun. It does not generate the force which the 
body expends, as was formerly believed, but merely 
liberates that which already exists. As, for ex- 



14 Consumption. 

ample, a nerve which is supplied to a muscle, upon 
being stimulated will only be capable of discharging 
the force in the muscle, and such a discharge or 
liberation of force will cause the muscle to contract. 
If such a contraction takes place in a muscle, the 
ends of which are inserted into bones, it will cause, 
as we have seen, a bending of the limb, and if it 
surrounds a blood-vessel or intestine, it will diminish 
or lessen the capacity of these organs. 

The mouth, stomach, liver, pancreas, bowels, which 
principally serve to prepare the food for ready ab- 
sorption by the blood ; the lungs, which are the 
organs for the taking in of oxygen and the throw- 
ing off of carbonic acid ; the kidneys, which eject a 
large amount of refuse matter ; and the skin, which 
is an excretory as well as a breathing organ ; all 
have an important bearing on the subject which we 
have under consideration. 



CHAPTER III. 

GENERAL NATURE OF CONSUMPTION. 

WITHOUT entering into a discussion of the inti- 
mate nature of consumption, one thing is certain, 
that above all other diseases it is one which is char- 
acterized by preceding weakness in one or both 
lungs, very frequently associated with a feebleness 
of the whole body, and it is enough for my purpose 
if I succeed in impressing the reader with a know- 
ledge of the tendency and general causes of the 
disease, so that the measures which are necessary 
for its prevention can be intelligently applied. 

Consumption is either inherited or acquired. The 
-influence of inheritance is currently believed to be 
the sole cause of consumption, but statistics, both 
from hospital and private practice, show that while 
this is true in the majority of cases, it is not abso- 
lutely true in all. The influence of these two factors, 
"although they eventually lead to similar morbid re- 
sults in the lungs, have such a peculiar mode of 
operation, and therefore it is necessary to give them 

15 



1 6 Consumption. 

separate attention, and so I will at once proceed to 
consider the nature of that variety of -the disease, 
or the tendency thereto, which is produced by her- 
editary agency. 

Many persons are laboring under that constitu- 
tional state commonly known as scrofula, which is 
marked by general debility. They are very apt to 
catch cold from the least exposure, are prone to 
sore throat, with, perhaps, permanent enlargement 
of the tonsils, swelling of the exterior glands or 
kernels in the neck, and are liable to suffer from 
cough and inflammation of the lungs. The debility 
is not so prominent as to disable them from perform- 
ing ordinary physical or mental labor, nay, often 
their mental powers are augmented, yet when they 
are brought into physical contest with individuals 
not so predisposed, their strength is almost inva- 
riably found to be inferior. This is true from in- 
fancy, although it manifests itself more decidedly 
towards puberty, and manhood and womanhood. 
Such children have not received sufficient vital 
stamina from their parents, and hence they are al- 
ways unequal to cope with their stronger neighbors 
in the severe struggle for existence. This is well 
attested by the fact that the greatest number of 
persons die from consumption between the ages of 
twenty and thirty years : just the period when the 
most rigid duties and demands begin to crowd them- 



General Nature of Consumption. 17 

selves upon a life, whose capital, both in matter and 
force, could hardly stem its own tide, and probably 
was on a decline before. Persons of this stamp 
generally make a slow and tedious recovery from 
any incidental severe sickness, and oftentimes retain 
a vestige of the disease. This is especially true of 
the inflammatory diseases of the chest, like pneu- 
monia, bronchitis, etc., which invariably leave the 
lungs in an enfeebled state, and thus gradually pre- 
pare them for the advent of consumption. 

Every organ in the body seems, or has a tendency 
to share in this general infirmity which usually brings 
on a multiplicity of complications. This is especially 
true of the digestive organs, for a weak stomach and 
bowels often give rise to indigestion, if not to actual 
dyspepsia, and to constipation ; deficient secretion of 
the pancreas or sweet-bread, the action of which, to- 
gether with the bile, is principally confined to the 
preparation of fats and oils for absorption, entails 
an aversion to fatty foods. The fact that there are 
a great many persons who carefully eschew all man- 
ner of fat from their diet, even from their very child- 
hood, is too well known to require any special no- 
tice here. This, indeed, forms such a prominent 
feature in the history of those who are predisposed 
to consumption that it has led some very eminent 
medical men to believe that this disease is wholly 
due to deficient pancreatic secretion. But whatever 



1 8 Consumption. 

influence such a want of secretion on the part of 
this organ may have in bringing about consumption, 
and no doubt it is important, it cannot be said to 
contribute more than its proportionate share to this 
predisposition. 

This imperfect digestion of fat therefore greatly 
interferes with that full and regular supply of force 
which is so essential in maintaining the working con- 
dition of the body, and the stored up fat in the 
body is seized upon and utilized for this purpose. 
It is evident, however, that such a state cannot re- 
main compatible with health, at least not for a very 
long time ; for if the income of fat is diminished, 
and its consumption even the same as before, the 
store of fat will sooner or later become totally ex- 
hausted. Now loss of weight, which is chiefly a loss 
of fat, is one of the incipient signs of consumption. 

But loss of force is not the only detrimental effect 
which follows a diminished fat supply, for fat is an 
essential ingredient in the composition of muscles, 
and so besides sustaining a loss of motive power they 
are at the same time also deprived of a structural 
element, and hence the increased muscular weak- 
ness which is so common in this disease. The 
heart, which is wholly a muscular organ, likewise 
depends upon the same source for a part of its 
structure, and for its motive power, also becomes 
embarrassed in its functions, and consequently 



General Nature of Consumption. 19 

there is always found an impaired circulation of the 
blood. 

Again the nervous system also shows signs of in- 
creasing debility. This manifests itself the earliest, 
perhaps, in those nerves called the vaso-motor nerves, 
which, as we have seen, acccompany and regulate 
the size of each and every artery in the whole body. 
The weakness of these nerves will suffer a disturb? 
ance in the balance which exists between them, and 
the blood-pressure in these vessels, and hence the 
blood-vessels become unsteady in their calibre. The 
slightest changes in the external temperature will 
greatly derange the circulation under such circum- 
stances, and produce a feeling of cold at one time, 
and a hot and flushed sensation at another. This 
cause, in combination with that of feeble heart- 
power, gives rise to coldness of the extremities, as 
well as to that chilliness which those liable to coa- 
sumption so frequently experience. A continued 
weakness of this portion of the nervous system will 
also, especially during the night when the ordinary 
stimuli of the day are withdrawn, relax the- walls of 
the blood-vessels to such an extent that they allow 
the water of the blood to pass through them, which 
appears on the surface of the body in the form of 
sweat. This is commonly called " night sweats " 
and is almost constantly associated with such a de- 
pressed condition of health. 



20 Consumption, 

I have already said that consumption may be ac 
quired as well as inherited, and I shall now briefly 
consider the possible causes of this form of the dis 
ease. This is usually induced by repeated inflam, 
matory attacks, of one, or both lungs, or parts of 
them. There cannot be the least doubt that a lung 
after a siege of bronchitis, or pneumonia, is left in a 
weaker state than it was before, even in a person 
who does not possess any inherent tendency to con- 
sumption, and this too after every trace of the in- 
flammation has apparently entirely disappeared. 
Repeated attacks of such a nature will eventually 
enfeeble the resisting power of the lungs to such 
a degree that they readily fall a prey to actual 
consumption. 

The hereditary as well as the acquired weakness 
of the lungs then, will sooner or later, if unchecked, 
result in a peculiar deterioration of the structure of 
these organs, which is known as pulmonary con- 
sumption. This is no more nor less than a low and 
miserable variety of inflammation, with its manifold 
complications — an inflammation in which the recu- 
perative power of the lungs is entirely gone, and 
hence they are destined to undergo premature dis- 
solution and death. 

I have thus far shown that the tendency to con- 
sumption is a state of general and special weakness ; 
how this weakness is shared by all the organs of the 



General Nature of Consumption. 21 

body, manifestly so by the organs of digestion, and 
by the nervous system ; how the weakness of the 
stomach leads to dyspepsia ; how the inefficiency of 
the pancreas brings on indigestion of the fatty foods ; 
how, owing to the exclusion of the fatty foods from 
the body, its stored up fat is consumed in carrying 
on the functions of the body ; how the muscular 
system and the heart suffer on account of the ab- 
sence of this kind of food ; how the nervous system, 
especially those nerves which preside over the blood- 
vessels become reduced in efficiency and thus be- 
come the indirect cause of chills and night sweats ; 
and now in the succeeding chapters I propose to 
consider those influences which tend to modify 
and check such a tendency. 



CHAPTER IV. 



INFLUENCE OF FOODS. 



Of all the agents which sustain the integrity of 
the body there are none that hold a higher place 
than foods. We have already learned that the foods 
supply all the materials which are necessary for the 
growth and repair of the body, as well as the force 
which is necessary to keep it in motion, Now while 
the former class, the nitrogenous and inorganic foods 
are indispensable to all living tissues, it is, after all, 
the force-producing foods which sustain the most 
exalted relation to the subject under consideration ; 
for scrofula, or the predisposition to pulmonary con- 
sumption is essentially a condition in which the forces 
of the body begin to be squandered before the mat- 
ter of the body, and hence it is imperative that these 
should be early and abundantly supplied. 

The force-value of our foods has been actually 
measured, and we have thus presented to us at a 
glance the superiority of one food over another as 
a force-producer. This is accomplished by the fol- 

22 



Influence of Foods. 23 

lowing method : The mechanical value of heat which 
is developed in burning or oxidizing a substance has 
been accurately determined by Mr. Joule of Man- 
chester, England, who discovered that the amount 
of heat which is required to raise one pound of wa- 
ter one degree Fahrenheit, will, under other circum- 
stances, raise a one pound weight to the elevation of 
772 feet, or what is the same thing, 772 pounds one 
foot high. He also proved the converse of this to 
be true, that 772 pounds falling the distance of one 
foot, or one pound falling the distance of 772 feet, 
will generate heat sufficient to raise one pound of 
water one degree Fahrenheit, and 772 foot-pounds is 
therefore called the mechanical equivalent of a unit 
of heat. From this important discovery the force- 
producing value of our most important foods has 
been correctly estimated by Prof. Frankland, as will 
be seen from the following table, in which the force 
value of one ounce of each substance is given in 
foot-tons. Thus, the force-producing value of one 
ounce of beef-fat (see table) when oxidized within 
the body is 351 foot-tons, i. e. the oxidation of one 
ounce of beef-fat will give rise to heat sufficient to 
raise 351 tons one foot high, or one ton 351 feet 
high ; that of one ounce of butter is equivalent to 
280.9 foot-tons, &c. 



24 



Consumption. 






TABLE.* 








Foot-tons 


of Enersrv in one 


Name of Substance. 


oz. 


of each Substance 


Cod Liver Oil, 




, 


353-7 


Beef Fat, . 




# 4 




35 1 - 


Butter, . 






, 


280.9 


Cheese, 








168.5 


Oatmeal, 






# 


*5 2 - 


Flour, 




. . 




148.5 


Arrowroot, 






, 


I 5 I -3 


Ground Rice, . 




. # 




I 4S-3 


Starch, . 






, 


i3S-°° 


Yolk of Egg, . 




# . 




127. 


Lump-Sugar, 






# 


I2 9-5 


Lean Ham (Boiled 


),. 


• . 




64.9 


Lean Beef, 






. 


55- 


Lean Veal, 




• • 




45-3 


Potatoes, 






, 


38.5 


White of Egg, . 




# . 




22.3 


Milk, . 






• 


24.3 



Now it is estimated that the human body at or- 
dinary labor and in a moderate climate expends 
about 2,800 foot-tons of energy during twenty-four 
hours, which is chiefly derived from the combustion 
of non-nitrogenous foods. From the above table we 
are at once able to see which articles of diet are 
best calculated to supply this enormous expenditure 
of energy. Beef-fat, with the exception of cod-liver 
oil, stands at the head of the list, butter comes 
next, then cheese, while lean beef, ham and veal 

* In the original table of FranklancTs, the force-value of each food 
is given in kilogrametres of force, but for the sake of convenience I 
reduced each to its equivalent in foot-tons. — Author, 



Influence of Foods. 25 

almost stand at the foot of the list as force-pro- 
ducers. There is also a marked difference in the 
force-producing capacity between the white and 
the yolk of the egg. Of course the force-producing 
value of our foods does not alone determine their 
full worth to the body, for we have already learned 
that the latter also requires food that will renew and 
build up its structures — food which contains the 
elements of bone, of muscle, of blood, of nerve, etc.; 
hence in a table of the comparative nutritive or 
building value of our foods, lean beef would stand 
at the head, and cod-liver oil, and beef-fat would be 
next to worthless by themselves. This shows us 
that neither class can supplant the place of the 
other. 

These 2,800 foot-tons of energy are mainly con- 
sumed by the body in carrying on the functions of 
the brain and nerves, of the heart and blood-vessels, 
of the lungs, of the stomach and bowels, of the 
myriads of glands, in .maintaining the bodily tem- 
perature and in performing muscular or manual 
labor. Now the tendency to weakness in those 
who are predisposed to consumption is mostly due 
to the fact that the body does not possess a sufficient 
amount of force wherewith to uphold these functions 
or processes in a normal way ; and hence we see the 
immense importance which foods play in contribut- 
ing the necessary elements under such circumstances. 



CHAPTER V. 



INFLUENCE OF AIR. 



AlR is as essential to life as food. In fact life 
can be continued for a number of days without 
any food ; while a total exclusion of air from the 
body for a few minutes only will suffice to arrest its 
vital machinery. This, although a popular compari- 
son between the relative value of food and of air, is 
obviously defective and unfair, for the air imme- 
diately on its entrance into the body is applied to 
its allotted duty, and therefore none is stored up. 
On the other hand the body requires some time in 
the preparation of the food before it is fitted for its 
final destination, and hence there is always some re- 
serve material on hand. Even after this store is 
absolutely exhausted it is well known that the body 
is capable of consuming its own tissues for susten- 
ance ; therefore it is evident that were the total sup- 
ply of food as abruptly cut off as in the case of air, 
the body would likewise come to a sudden standstill. 
The most essential part of the air is the oxygen 

26 



Influence of Air. 2*J 

which constitutes about one-fifth of its bulk. I have 
already stated that before the non-nitrogenous foods 
can manifest their latent energy they must combine 
with oxygen, which enters the body through the 
lungs. Now in this work of oxidation or combus- 
tion, beside preparing the useless material in the 
body for various ends, about thirty ounces of oxygen 
are consumed by an adult during every twenty-four 
hours. The chemical union in the body between 
the oxygen on the one hand, and the carbon and 
the hydrogen of the non-nitrogenous foods on the 
other, results in the production of carbonic acid and 
watery vapor which are chiefly thrown off by the 
lungs. 

The bad effect of impure air, or air deficient in 
oxygen on those who are inclined to become con- 
sumptive has been proven to be very great. Al- 
though no place or climate in the world is totally 
free from this disease, there is yet a marked differ- 
ence in regard to its degree of prevalence in various 
localities. Places in which is found a pure and dry 
atmosphere bear a very favorable contrast in this re- 
spect to those where the air is less pure and more 
humid. This comparative exemption not only holds 
true as far as the masses are concerned, but also of 
individuals who even reside in the same locality, 
provided there are present different climatic or at- 
mospheric conditions. Thus, if other things are the 



28 Consumption. 

same, those individuals who breathe the purest ail 
are less liable to this disease than those who are de- 
prived of this privilege and duty. 

Continued breathing in a limited atmosphere will 
exhaust all its life-giving properties. This, as we 
have already seen, is due to a diminution of its oxy- 
gen, and at the same time saturating it with car- 
bonic acid, water, and other exhalations. Ham- 
mond found that a mouse in a closely confined space 
was able to live only forty-five minutes. Two hun- 
dred and sixty out of the three hundred Austrian 
prisoners, who were confined in the " Black Hole " 
at Calcutta, only lived eight hours. Whatever the 
deleterious effects of carbonic acid and other bodily 
exhalations may be on the function of breathing, 
and undoubtedly they are weighty, I am convinced 
that heretofore physicians have fallen into the man- 
ifest error of attributing too much to the supposed 
influence of these poisons, and have, in a great 
measure, lost sight of the most important factor in 
the problem, viz : the deficient supply of oxygen. 
For it has been proven by experiment that animals 
can live in an atmosphere rich in carbonic acid, pro- 
vided they receive a requisite supply of oxygen at 
the same time. And again we know that carbonic 
acid is an essential ingredient of the blood in its 
healthy state, and hence its effects cannot be so ex- 
ceedingly fatal as we are accustomed to assume. On 



Influence of Air. 29 

the other hand it is beyond the power of any person 
to account for all the morbid effects which the body 
sustains from breathing an unhealthful atmosphere 
on the score of carbonic acid poisoning, or that of 
other bodily exhalations ; for such effects (as I shall 
endeavor to show) bear no legitimate relation what- 
ever to the poisonous influence of these latter 
agents. 

The great importance of foods in relation to life 
has been discussed in the preceding chapter, and I 
have also stated in the beginning of the present 
chapter that oxygen is as essential as food in this re- 
spect. Oxygen not only forms an indispensable part 
of every organ in the body, but its separate presence 
is also necessary to insure bodily action. The chem- 
ical union between it, and the carbon and hydrogen 
of the food, gives rise to energy, and the latter on 
the one hand supplies the body with power to per- 
form its functions, and on the other hand with heat 
to keep up its normal temperature. We can thus read- 
ily perceive that a deficient amount of this vital gas 
must necessarily entail great inconvenience and in- 
jury on the body, and the reason becomes intelligi-. 
ble to us why such persons " soon become pale and 
partially lose their appetite, and after a time decline 
in muscular strength and spirits. " Why " the 
aeration and nutrition of the blood seem to be in- 
terfered with," and why " the general tone of the 



30 Consumption. 

system falls below par/' * * * * And why 
" such persons do appear to furnish a most undue 
percentage of phthisical (consumptive) cases * " 

Such is but the inevitable result, for if bad or in- 
sufficient food is so potent in enfeebling the body, 
and thus aggravating the tendency to consumption, 
surely a deficient supply of oxygen will bring about 
a similar state of things, for food and air are of equal 
importance to life. 

The air, then, is consumed by the body, its oxygen 
is exhausted, and in place of this it receives the 
bodily exhalations ; hence in order to keep the air 
in a pure and healthy condition, it becomes neces- 
sary to keep it in constant motion — to allow the fresh 
air to come in contact with the body, and abduct 
the foul air from it — and this leads me to the sig- 
nificant subject of ventilation. It is estimated that 
each adult person requires about 3,000 cubic feet of 
fresh air per hour. This amount is readily secured 
in the open air where the latter is in perpetual 
motion, and it is also a comparative easy matter to 
thoroughly ventilate a house during the summer 
season, when the doors and windows remain open 
most of the time ; but in winter, when these inlets 
and outlets are closed up, ventilation becomes a 
question of great difficulty. 

*The whole quotation is from Parker's " Practical Hygiene," 
p. 122. 



Influence of Air. 31 

In order, therefore, to supply 3,000 cubic feet of 
fresh air to an adult person occupying a room twelve 
feet square and ten feet in height, it is necessary to 
change the whole volume of air in the room twice 
in one hour ; for two persons inhabiting the same 
room, four times in the same time, and so on. This, 
in most instances, is accomplished by heating the air 
in the room, and thus making it lighter. The un- 
equal pressure produced in this way between the air 
in the room and that on the outside, causes the outer 
air to flow into the room through properly provided 
inlets, and forces the warmer and useless air out of 
the room through places of egress. 

It is not alone for the purpose of ventilation that 
the air of an apartment must needs be warmed, but 
warmed air is also of great value in preserving the 
healthy temperature of the body. The body in a 
healthy and comfortable condition is nearly always 
higher in temperature than the surrounding medium 
of air, hence there is a constant loss of heat from 
its surface. If this heat-loss should become too 
great, on account of the depressed atmospheric tem- 
perature, it is obvious that the body will suffer to 
a very marked degree. It is for this reason that the 
ventilation and warming of houses are so intimately 
connected, and that it is impossible to consider one 
without the other. 

Again, in order to have good and healthful venti- 



32 Consumption. 

lation in a room or in a dwelling, it is essential to 
introduce the air in such a manner that no percep- 
tible draught be produced. By not properly guard- 
ing against a too rapid flow of air through an apart- 
ment, the air in it grows cold, and exposes the 
occupants to a source of " colds/' Especially is 
this precaution of great value to those who are 
liable to consumption, for, as already stated, such 
persons are extremely susceptible to the slightest 
changes in the surrounding temperature. 

For the complete ventilation of a dwelling then, 
pure air must be admitted from the outside in such 
a manner as to cause no perceptible draught, be 
warm, and made to escape. Whenever the air cannot 
be warmed previous to its ingress, it ought not by 
any means to be let in near the floor. If this were 
done, the cold air, by virtue of its greater weight, 
would remain near the floor, and by being thus un- 
equally distributed would expose different portions 
of the body to an uneven temperature, and be a 
prolific source of evil. When properly admitted 
above, it diffuses over the room, descends to the 
floor, becomes warmed, and breathed rises again, 
and makes its exit at the appointed place. My re- 
marks here pertain rather to the ventilation of dwell- 
ing houses than to that of public buildings, where 
many varied artificial contrivances are necessary for 
this purpose. Where no special facilities exist for 



Influence of Air. 33 

ventilation, as is the case with most of the dwell- 
ings constructed at present, the best plan for purify- 
ing the air is by lowering the windows from the top. 
To distribute the air efficiently througout a room a 
light board, or strip of zinc, should be fastened along 
the whole length of the upper sash in #n oblique 
position, which will conduct the air upwards, cause 
it to strike the ceiling, spread and grow warm, par- 
tially at least, before it falls on the inmates. Under 
these circumstances, the . lowered top window will 
also answer for a reasonably good outlet for the 
foul air. Of course it is assumed here that the 
ordinary coal or wood stove is employed for heat- 
ing. 

It is beyond dispute that the open fire place, or 
the old-fashioned fire-hearth is by far superior to any 
other mode of ventilation and warming. The cold 
air being admitted in the upper part of the room, 
either through lowered windows, arranged in the 
manner indicated above, or through other appliances 
such as cold air tubes, etc., is warmed, heated and 
taken up the chimney by the draught created by the 
fire. In this way as long as the fire is kept up good, 
thorough ventilation as well as good warming can 
always be assured. Stoves are now manufactured 
with open grates, which in a great measure answer 
the purpose of a low grate fire, where the latter can- 
not be secured. 



34 Consumptio7i. 

Another very common mode of ventilating and 
warming houses consists in heating the air by means 
of a furnace before its admission into the building. 
The air should be obtained pure and uncontamina- 
ted from the outside. Very frequently, however, no 
better air is supplied than that afforded by the cel- 
lar in which the furnace is stationed. Now cellar 
air is not the most healthful air in the world for this 
purpose ; for, besides being unexposed to the vivi- 
fying influence of sun-light, it is liable to contain 
germs of poison which are given off by the animal 
and vegetable matter usually stored within its walls. 
Even when the air is taken from the outside great 
care is needful to obtain it from a source which is 
undefiled by emanations from sewers, drain pipes, 
or from undrained surfaces. Means of egress for the 
foul air thus warmed should be provided near or 
at the ceiling. 

Again it is of primary importance that the air 
should have its moisture restored which it loses 
through the process of heating. For if the air is in- 
troduced too dry it absorbs the moisture of the 
mouth, throat and lungs, irritates those organs and 
predisposes them to inflammation. To obviate 
this the air after being heated must be exposed to 
a reservoir of water provided in the furnace, which 
supplies the requisite amount of moisture. When- 
ever this provision is not made, a pan or shallop 






Liflucnce of Air. 35 

vessel of water should invariably be placed on or 
near the register. 

The temperature of a room ought to range from 
60 to 70 degrees Fahrenheit, according to the com- 
fort and feelings of the occupants. 



CHAPTER VI. 



INFLUENCE OF SOILS. 



THE soil not only produces the food of man, but 
also exerts an enduring influence on his health. 
The form of the surface, the nature of its composi- 
tion, the character and inclination of the underlying 
rocks, are all elements of vast importance in deter- 
mining the welfare or misery of mankind. Soil-damp- 
ness is now proven to be one of the most prolific 
causes of disease, and especially of that malady 
which we have under consideration. Dr. Henry I, 
Bowditch in his excellent paper on The chief cau- 
ses of consumption in New England, illustrates most 
forcibly the close connection between consumption 
and soil-dampness, and its comparative absence 
where the air is more free from moisture. The facts 
which he has collected in proof of this point are 
many ; but, perhaps, the most noted example is that 
of the town of Greenland, New Hampshire, which 
contains about seven hundred and twenty residents, 
very nearly equally divided, according to the nature 

36 



Influence of Soils. 37 

of the soil, into three districts. The first is a high, 
dry and sandy soil ; the second is more moist, and 
the third is composed of low marshes. During a 
period of ten years three persons died of consump- 
tion in the first, five in the second, and ten in the 
third district. Prof. Parkes* in commenting on the 
connection between diseases and soil-moisture, uses 
the following language : " In some way which is 
not clear, a moist soil produces an unfavorable ef- 
fect on the lungs ; at least in a number of English 
towns, which have been sewered, and in which the 
ground has been rendered much dryer, Buchanan 
has shown that there has been a diminution in the 
number of deaths from phthisis (consumption). Dr. 
Bowditch of Boston (U. S.), and Dr. Middleton of 
Salisbury, noticed the same fact some years ago. 
Buchanan's evidence is very strong as to the fact of 
the connection, but the nature of the link between 
the two conditions of drying of soil and lessening 
of certain pulmonary diseases is unknown. It is cur- 
ious how counter the observations run to the old 
and erroneous view, that in malarious — and there- 
fore wet — places there is less phthisis (consumption). ,, 
Now since air- and soil-moisture are such fruitful 
sources of consumption it may well repay us to in- 
quire into the mode of action of these causes in pro- 

* " Practical Hygiene," p. 331. 



38 Consumption. 

ducing consumption, and if the effort to establish 
the exact relation, or " the nature of the link " be- 
tween the cause and effect in this case is successful 
it is certain that the necessary protective measures 
can be intelligently, if not more effectually applied. 

Atmospheric air is not confined above the surface 
of the earth, but it extends deep into its structure, 
where it becomes soil air. In this condition it is 
very rich in carbonic acid, and poor in oxygen. 
Nearly all rocks contain air, some as high as thirty 
per cent., and loose soil as much as six times its own 
volume. This underground air is in a continual up- 
ward circulation, which is determined by the daily 
changes of temperature, amount of rainfall, etc. 

The soil likewise contains a large amount of water, 
which exists as soil-moisture and soil-water — the 
moisture occupies the upper strata of soil, and is 
really nothing but a sort of evaporation of the under- 
lying water. Same as in the case of soil-air, the sur- 
face-heat, winds, etc., facilitate its ascension to the 
surface. The level of the soil-water varies from 
complete exposure at the surface down to many 
hundred feet at different points. This depends upon 
the amount of rain, permeability of the soil, etc.;' 
and whenever it rises it displaces and forces out the 
superincumbent air. Almost all soils also contain a 
certain amount of animal and vegetable matter. 

Thus we find in the soil moist air loaded with car- 



Influence of Soils. 39 

bonic acid, watery vapour, or, at least, water in a 
very fine state of division, animal and vegetable 
matter. We have also observed that the heat of 
the sun, winds and rain," have the power of bringing 
these substances out of the soil upon the earth's 
surface, and thus cause them to intermix with the 
atmospheric air. From the constant operation of 
at least one, and at times, and in some places, all 
three of these agents, we must at once conclude 
that soil-exhalation is going on more or less all the 
time. 

On investigation I think the reason will appear 
why these various agents of the soil have such a 
telling influence on health and life. In the first 
place it is essential for the body, in order to possess 
full and unimpeded activity, to throw off a large 
amount of foul and used-up material through the 
lungs and skin. Especially is this true of the latter 
organ, for when the skin is coated over with some 
impervious substance, death takes place in a very 
short time. Death under such circumstances is, no 
doubt, on the one hand, due to the fact that the 
material which ought to be thrown off is retained in 
the blood, and becomes a source of poisoning ; and, 
on the other, by abolishing the function of skin- 
breathing. It is well proven that the blood absorbs 
some oxygen from the air, and discharges some car- 
bonic acid through the skin. The amount of ex- 



40 Consumption. 

cretion from the latter organ alone amounts to nearly 
two pounds in twenty-four hours, and consists of 
carbonic acid, watery vapor, and animal refuse. Now 
the quantity of matter excreted, as well as the ve- 
locity with which it passes through the skin in a 
given time is, if other things are the same, in exact 
proportion to the amount of resistance which must 
be overcome on the outside of the body ; that is, if 
the outside pressure is small in comparison to that 
on the inside of the skin, its passage is rapid, and if 
this difference is less marked, it is diminished. And 
it is a noted fact that moisture causes a heaviness of 
the air, which exerts a greater pressure on the out- 
side of the body than air without moisture, and thus 
becomes a direct obstruction to the lungs and skin 
in the discharge of their respective duties. The 
truth of this is well exemplified in the invalid whose 
feeble functions are still further depressed by a close 
and damp atmosphere, and invigorated by an oppo- 
site condition. This difference of feeling is to a 
greater or less degree experienced by the hale and 
hearty, and even animals, as every horseman well 
knows, cannot perform as much work in sultry as in 
fair weather. 

In the second place the body suffers greater in- 
jury when the moisture is cold, than it does from 
simple moisture alone. This effect upon the body 
is of a different nature from the foregoing, and is 



Influence of Soils. 41 

brought about in the following manner: The body, 
in order to maintain its functions in a healthy state, 
^must absolutely possess a uniform standard of tem- 
perature (about 99^ degrees of Fahrenheit's ther- 
mometer). Now moisture, which is nothing else 
than finely divided water, at any rate is a great ab- 
sorber of heat, and if from any cause it becomes 
cool, this property of absorption is intensified, and 
so it quickly seizes upon the heat of the body, and 
deprives it of one of its most essential elements. 
Cold soil-moisture is generally produced in localities 
which are in a great measure shielded from the rays 
of the sun, as in swamps, marshes, lowlands, etc., 
and after it diffuses into the atmosphere above, it 
renders the latter cold and unhealthful. This dif- 
ference of atmospheric temperature is very strik- 
ingly shown to a person who is travelling over a tract 
of undulatory country after sunset, and especially if 
the depressions of the surface are covered wholly or 
partly with marshes, or contain a stream of water. 
It will be experienced that the elevations are almost 
invariably dry and warm, and that the lowlands are 
cold, damp and disagreeable. 

Now the reason that persons who are predisposed 
to scrofula, are more apt to feel the effects of ex- 
ternal cold than others who are stronger, lies in the 
fact that their heat-producing power is enfeebled to 
a similar degree with the other bodily functions, 



42 Consumption. 

and they are therefore just able to generate that 
amount of heat which is necessary to carry on the 
bodily operations, and very little, if any more ; 
hence such individuals can but illy afford to lose 
much heat, and it is very clear, if they come in con- 
tact with a medium like cold damp air which rapid- 
ly abstracts the bodily heat, and if such a condition 
continues for any great length of time, that they 
must suffer grave injury. 

Cold air-moisture may however bring about the 
feeling of coldness or chilliness in a manner some- 
what different from the above. That system of 
nerves (the vaso-motor) which presides over and 
regulates the size of the blood-vessels throughout 
the body, is, as I have already remarked, also in an 
enervated state, and hence is readily disturbed by 
changes in the surrounding temperature. For we 
well know that cold through these nerves has the 
power of contracting blood-vessels, and since the 
blood-vessels of the external parts, or surface of the 
body, are more exposed to changes in atmospheric 
temperature than those inside, it is evident that the 
former will readily contract when brought in contact 
with cold, and drive the blood into the interior parts 
of the body. The exterior parts of the body are 
ihus without a due supply of blood and heat, which 
gives rise to a sensation of coldness or chilliness, 
while the interior of the body contains more than 



Influence of Soils. 43 

its complement of blood and heat, and thus, conse- 
quently, produces a feeling of internal fever. In a 
short time the body tends to restore its former bal- 
ance in the circulation of the blood, but very often, 
especially if the disturbance has been severe, the 
blood in distributing itself from the interior to the 
exterior parts of the body, owing to the feeble re- 
straint offered by the blood-vessels, overbounds its 
normal limits and engorges the superficial vessels, 
thereby causing a hot skin which is usually relieved 
by a process of free and profuse sweating. By ex- 
posing the body to excessive changes of atmos- 
pheric temperature, we are enabled to perceive how 
by a series of such oscillations of the blood from 
the exterior to the interior, then -back again, it is 
possible to produce some such morbid state of the 
body as " chills and fever.* " 

This also makes clear to us how soil-moisture, be- 
sides hindering free exhalation, and wasting bodily 
heat, can produce serious internal disorders by driv- 
ing the blood from the surface to the inner organs, 
thus giving rise to engorgement and torpidity of the 
liver, stomach, bowels and lungs r conditions which 
are invariably associated with chills and fever. 

*This theory of the production and development of "chills and 
fever," or fever and ague, through the agency of temperature changes 
is not new, but has been very ably and logically set forth by Dr. J. 
R. Black of Newark, Ohio, as far back as 1867. See vol. 18 of 
Transactions of Ametican Aled. Association. — Author. 



44 Consumption. 

It is manifest, then, that everybody, and especial- 
ly those persons who are predisposed to consump- 
tion, ought to realize the fact that it is impossible to 
withstand the deleterious influence of such a locality 
for a very long period, and that one of the most 
pressing questions with them is, how to avoid these 
evil causes. 

The principal soils which are selected for habita- 
tion, in civilized countries at least, are the sandy or 
gravelly, and the clayey. The former of which is 
loose and porous, and readily frees itself of excessive 
moisture by filtration and evaporation, while the lat- 
ter of which is very dense and compact, prevents the 
water from soaking through it, and retains it within 
its meshes for a very long time. It is evident, since 
most water is derived from rain-fall, that the chief 
aim in counteracting the production of soil-moisture 
lies in the first place in endeavoring to limit as far 
as possible the accumulation of water in the soil, 
and in the second place in exhausting or diminish- 
ing that in the soil. The first of these indications 
is generally fulfilled by paving the surface, and by 
conducting the water into streams through well- 
appointed channels. Paving prevents absorption of 
water by the soil, and also interferes with the evap- 
oration of moisture. All sloping surfaces naturally 
drain themselves. The second is accomplished by 
deep underground channels which lead the water 



Influence of Soils. 45 

and moisture to more permeable strata of soil or 
rock. Sometimes an impervious stratum of soil is 
underlaid by one of sand, and whenever this is the 
case, drainage is effected by cutting a number of 
small perpendicular openings through to the sand 
stratum, and afterwards filling them up with gravel 
or sand — thus allowing the water to filter through to 
the sandy soil below." 

A prolific cause of dampness in dwellings, and 
one which in a great many instances is wholly unex- 
pected, are cellars. Every precaution must be taken 
to make them dry : the walls and floor ought to be 
well paved, and drained with good outlets, or with 
perpendicular holes sunk into the ground floor, and 
these filled with sand and gravel. 

Rivers and streams, by loading the atmosphere 
with moisture and by a continuous drainage of its 
heat, tend to make the regions through which they 
flow, cold, damp, and unhealthful. Stationary bod- 
ies of water, which are store-houses of heat, give out 
their warmth to their surroundings, and thus have a 
tendency to equalize the temperature, and produce 
a more healthful impression. 

* For a more thorough consideration of the important subject of 
drainage I would refer the reader to the following standard authori- 
ties : Manual of Practical Hygiene, by E. A. Parkes ; Sanitaty En- 
gineering, by Baldwin Latham. 



CHAPTER VII. 



INFLUENCE OF CLOTHING. 



THE intelligent farmer is well aware that by af- 
fording warm shelter to his live stock in winter he 
not only protects the life and health of his animals 
from the immediate inclemency of the season, but 
that he also saves in food by this operation. He 
knows that in some way he is enabled to feed less 
hay, oats, and corn by such a wise provision. The 
cause which renders this economy possible is not 
very far to seek : for the bodily heat is derived from 
the food which the animal takes in, and a cold and 
unprotected stable deprives the body of a greater 
amount of heat, and of more food in consequence, 
than one under opposite conditions. 

But, in order to make this subject as lucid as pos- 
sible, let us inquire a little closer into the mode in 
which a warm stable protects its inmates. Natur- 
ally, in a cold climate, there is a constant flow of 
heat from the body to its environment, and also a 
constant reflow of cold from the environment to the 



Influence of ClotJiing. 47 

body, and certainly if this exchange should be car- 
ried to excess the warmth of the animals would be- 
come reduced to its lowest limits ; hence there must 
be a check somewhere to the outflow. Now it is 
well known 'that air, when locked up, or made to as- 
sume an almost stationary condition, is a very poor 
conductor of heat and cold. Such atmospheric 
quietude is exactly secured in a stable which is con- 
structed of double or hollow walls, and this space 
filled in with fine straw or some other loose material. 
Air closed up in such a manner is warmed by the 
heat obtained from the animals, and is of course in 
a constant state of circulation from within outwards, 
and from without inwards, but by this arrangement 
the motion of the air is restricted to such a velocity 
that the animal does not lose enough heat to make 
it feel uncomfortable, or make the cold perceptible. 
We are already aware that it is of primary impor- 
tance for the body to be constantly immersed in air 
so that the abundant exhalation which is given off 
by the skin may be carried off, and that the aeration 
of the blood which takes place through this organ 
may be readily effected. Air in contact with the 
body, for even a short time, becomes warm, ascends, 
and is supplemented by cooler air, and as long as 
the temperature of the environment is very nearly 
the same as that of the body, the latter does not 
suffer much inconvenience ; but if the external tern- 



48 Consumption. 

perature is depressed a great deal, it is evident that 
the influx of cold air which is brought about in this 
way, would soon divest the body of all its necessary 
warmth. Now just precisely that relation which the 
warm stable bears to the horse, our clothing bears 
to the body. Clothing is but the medium which 
tempers and regulates the cold air in such a manner 
as not to produce a sensible impression on our bod- 
ies when it lights upon them. The space between 
the horse and the walls of the stable, in a rough way, 
represents that between the skin and the clothing, 
and the double wall represents the clothing itself. 
The reason that woolen clothing affords more pro- 
tection against cold than any other material is 
because it is loose in texture, and consequently em- 
bodies a large amount of air which, as we have seen, 
is a bad conductor both of heat and of cold. The 
cold air from the outside, as soon as it enters the 
garment is tangled and hemmed in on every side by 
the innumerable meshes of the latter, and in this 
way the rapidity of its inward motion is reduced to 
a minimum, which gives sufficient time to the body 
to elevate it to a temperature like its own. 

The slowness or rapidity with which the various 
articles of clothing conduct heat, depend altogether 
upon the looseness or density of the fibres of which 
its texture is composed ; or, in other words, upon 
the amount of air which they are capable of contain- 



Influence of Clothing. 49 

ing. This is well shown in wadding, or even in wol- 
len clothing itself, for when these materials become 
compressed from wear and age, or from other 
causes, their capacity for retaining air is diminished 
to a marked degree, and it is also well known that 
in the latter state they are less fitted to resist the in- 
fluence of cold on the body than in the former. 
Cotton, linen, and silk are more compact and con- 
tain less air than wool, and consequently are not so 
well adapted for conserving the heat of the body as 
the latter Prof. Hammond has tested the heat- 
conducting power of some clothing materials with 
the following results : He employed a vessel and 
noted the length of time which it required to cool 
from 150 Fahr. to 140 Fahr. 



Vessel uncovered 




MIN. 

15 


SEC. 
II 


" covered with cotton shirting, 


9 


42 


tt a tt 


linen " 


7 


24 


tt tt it 


white flannel, 


12 


35 


tt tt a 


dark blue woolen 








cloth, 


14 


5 


tt tt tt 


light blue woolen 








cloth, 


13 


5o 



From these experiments it appears that not only 
are woolen materials superior to cotton and linen as 
non-conductors of heat, but that even identical ma- 
terials have different heat-conducting capacity where 



50 Consumption, 

their colors vary. Thus dark blue woolen cloth re- 
tains the same amount of heat longer than light 
blue woolen cloth, and white flannel, which is also 
composed of wool, is inferior in this respect to the 
latter. Everyone is familiar with the fact from ex- 
perience that black is much warmer than light 
clothing, and all this difference seems to be due to 
the different heat absorbing power which various 
colors possess. 

Therefore one of the chief uses of clothing is to 
conserve the warmth of the body in cold climates, 
and in cold seasons ; but there are climates and sea- 
sons which are as warm, and at times warmer, than 
the animal body, and for this reason the same kind 
of clothing is not adapted to all conditions. Cot- 
ton, linen, and silk, all of which transmit heat with 
great facility, make the most suitable and comfort- 
able clothing in warm weather. It is not, however, 
my purpose to dwell on the influence of light cloth- 
ing on the body in mild climates, for I am 
thoroughly convinced that a greater number of peo- 
ple suffer from the effects of insufficient clothing in 
cold weather, than from being improperly clad in 
warm weather ; for in the latter case the body has 
certain powers by which it can recompense itself, 
while in the former it has none. 

Woolen clothing is not only valuable as a con- 
servator of heat under ordinary circumstances, but 



Influence of Clot J ting, 51 

it is equally efficacious in guarding the body against 
too sudden changes of bodily temperature which 
follow protracted physical exercise. . The increased 
heat, developed during such exercise, transforms a 
portion of the water of the body into vapor, moist- 
ure or perspiration, which, as we are already aware, 
is a great absorber of heat and thus greatly facilitates 
the process of cooling. It is evident, however, that 
when this process is carried on as actively as it is 
after severe labor, it would soon abstract more heat 
than the body can afford to lose, but just here the 
woolen fabric intervenes and asserts its usefulness 
.by absorbing the moisture and re-condensing it into 
water, and in this way again giving back a part of the 
heat which was made latent, or consumed in the 
process of evaporation (for vapor contains more heat 
than water). 

But under certain circumstances this very prop- 
erty of imbibing moisture or water which all woolen 
goods possess, becomes a source of danger to the 
wearer, for any substance which takes up moisture 
also has the power of retaining it, and in this con- 
dition woolen clothing instead of preserving the 
heat of the body as it does when dry, dissipates it. 
"Cotton, silk and linen have less affinity for moist- 
ure and hence are not so injurious in this respect ; 
yet all kinds of damp clothing possess a detrimental 
influence on health and ought to be removed with- 



$2 Consumption. 

out delay. From this we learn the reason why 
damp feet are such frequent sources of colds and 
diseases. A large amount of blood circulates 
through the feet and when the latter are enveloped 
in damp and wet clothing they afford a ready means 
for abstracting the heat of the body as fast as it is 
carried there by the blood, and in this way produces 
coldness and chilliness of the whole frame. Not 
only is it of the highest importance to keep the feet 
dry, but it is equally necessary that they should be 
kept warm. 

Again, our bed-clothing bears a most remarkable 
influence on health. Being warmed by the heat of 
the body in a way similar to ordinary clothing it is 
plain that the best non-conductor of heat produces 
the most useful bed clothing in cold weather. Yet, 
if other things are equal, the same clothing does not 
protect the body as effectually in the horizontal or 
lying position as in the upright ; for in the former 
attitude nearly one half of its surface directly es- 
tablishes a warm air current which leaves the body 
at a right angle, and in this manner gives free vent 
to its warmth ; while in the latter position a current 
/is produced likewise, but it moves in a line which is 
in contact with the body, thus surrounding the latter 
by a warm stratum of air. We must also take into 
consideration that during sleep all the functions and 
processes of the body are reduced in activity, and 



Influence of Clothing. 53 

on this account generate less heat than during the 
waking hours, hence this is another reason why the 
body should be thoroughly protected by warm 
clothing during sleep. 

Underclothing should also be worn constantly by 
such persons in summer and in winter, both for the 
purpose of retaining the heat of the body and ab- 
sorbing the perspiration or moisture which is gen- 
erated during exercise. Without exception this 
kind of wear should be woolen in cold, and thin wool 
or cotton and wool, or silk in warm weather. The 
chest should receive extra attention and protection 
in very rough and inclement weather. We are now 
in a position to properly appreciate the immense 
value of good clothing to those scrofulous individu- 
als who barely have sufficient vitality to manufac- 
ture heat enough to carry on the necessary opera- 
tions of their bodies. 



CHAPTER VIII. 



INFLUENCE OF LIGHT. 



THE action of sunlight is, perhaps, not so dis- 
tinctly perceptible on animal as it is on vegetable 
life, yet its influence is no less certain and power- 
ful in the former than in the latter instance. 
Every one knows, of course, how difficult it is to 
raise plants in badly lighted apartments, and how 
quickly they sprout forth under the stimulus, and 
even follow the motions of the sun ; but it is not 
so well understood that the absence of sunlight 
restrains the growth and development of the ani- 
mal body. 

Milne Edwards, a noted French physiologist, il- 
lustrates this by the following experiments : Frog's 
eggs were placed in two vessels full of water, one of 
which was covered all over with black paper, and so 
protected from the rays of the sun, while the other 
was freely exposed to light. The eggs in the vessel 
to which light had unobstructed access developed 
regularly into tadpoles, while those in the dark ves- 

54 



Influence of Light. 55 

sel gave rise to aborted embryos. He then, in the 
next place, put tadpoles under similar conditions, 
and found that they grew into frogs without diffi- 
culty, while those in the obscured vessel were either 
stunted or remained in the same condition. Prof. 
Hammond, of New York, extended these researches, 
and discovered that when undeveloped tadpoles in 
the dark vessel were freely exposed to sunlight they 
resumed growth and developed into frogs. Pursu- 
ing this same subject, the latter celebrated author 
says : * " Upon another occasion I took two kittens 
of the same litter, and when they were twenty days 
old weighed them accurately. One weighed eighteen 
ounces and the other eighteen ounces and a half. 
The first was placed in a box to which the light of 
the sun had free access, the second in a similar box, 
to the interior of which no light could reach. Both 
were fed alike, and in all other respects, save as re- 
gards the light, were kept in the same condition. 
At the end of the first five days, number one weigh- 
ed twenty-two and a half ounces, while number two 
weighed but twenty and three-quarters ounces. At 
the end of a second period of five days, number one 
had attained a weight of twenty-four ounces, while 
number two scarcely weighed twenty-two ounces. 
The two animals were now placed together in the 

* Sanitarian, vol. i, p. 59. This is an excellent monthly journal 
of health, and ought to find its way into every household. — Author. 



56 Consumption. 

box which was exposed to the light, and at the end 
of the third period of five days each weighed within 
a fraction of twenty-five ounces." 

Now, man is a wonderfully complex being, and is 
surrounded by a multitude of stimulants. The 
highest structure of his body is the brain and ner- 
vous system, and we have many reasons for believ- 
ing that sunlight is a special stimulant to this struc- 
ture. This seems obvious, for the eye, through 
which we receive the greatest number of impressions 
from the external world, is so closely connected 
with, and in truth we may say, is a continuation of 
the nervous system. It is, indeed, held by some of 
the most distinguished men of the present time that 
the eye, with all its appendages, was principally gen- 
erated by the influence of sunlight throughout the 
different stages of its evolution. This belief is con- 
firmed by the well-known phenomenon that animals 
which live in total darkness, like the fishes in sub- 
terranean lakes, are devoid of eyes, as well as of the 
optic nerves, or the great nerves of the eyes, which 
transmit the light from the eyes to the brain in 
other animals not so conditioned. 

Now if, as we have reason to believe, it is true 
that the nervous connection between the eye, as 
well as the eye itself, was brought about by the in- 
strumentality of light, then we have evidence which 
indicates that sunlight is a stimulant or excitant to 



Influence of Light. 57 

the whole nervous system, for certainly if it acts on 
one portion, as we know it does on the eye and its 
nerve, it is not unreasonable to suppose that it acts 
on other parts also. 

This inference that the influence of light pene- 
trates every part of the nervous system, receives 
proof from the feeling which a person experiences 
when he enjerges from a dark to a well-lighted room. 
His breathing and pulse become accelerated, and it 
really appears to infuse a new spirit of activity into 
every recess of his frame. The stimulating influence 
of sunlight on the animal economy is clearly demon- 
strated, at least in a negative way, by the course 
which is pursued among certain classes in the fat- 
tening of geese. These animals are placed in dark 
cellars, closely confined in boxes, and stuffed with 
corn and water. It is well known that one of the 
chief objects to be gained by the operation is the 
enormous development of the liver which takes 
place in a very short time under these circum- 
stances. In a like manner the farmer knows that 
the cheapest and most expeditious mode of pre- 
paring his oxen for the butcher's knife, is by 
keeping them quiet in small and poorly lighted 
stables. Now the principle which underlies or con- 
trols the accumulation of fat in the animal body, 
and which is perhaps blindly carried out in the 
above manner, rests on the physiological truism that 



58 Consumption. 

bodily activity and bodily waste proceed hand in 
hand ; i. e. y if the functions of the body are accelera- 
ted or retarded, a corresponding consumption or col- 
lection of fat ensues — hence, in order to save the fat 
and allow it to accumulate, the motion of these ani- 
mals is restricted by the most rigid methods. And 
one of the means for the achievement of this perfect 
quietude is close confinement, but what interests us 
the most here is the fact that this end can only be 
successfully secured by shutting out as much sun- 
light as possible ; thus proving substantially that 
sunlight has the power to quicken and invigorate 
the process and functions of the body. For, if sun- 
light transmits no impulse to vital action, then the 
process of fattening might be carried on equally well 
in light or darkness, which, as we have seen how- 
ever, is not the case. Moleschott gives us still fur- 
ther evidence that sunlight has the capacity for pro- 
moting vital activity. For, if other things are the 
same, the amount of carbonic acid which is thrown 
off from the body in a given time is equivalent to 
its interior organic movements during the same time, 
and by experiment he found that frogs exhaled 
more carbonic acid in daylight than in darkness, and 
that the production of carbonic acid increases in 
proportion to the intensity of the light which is 
employed. 

Thus then we have much reason for concluding 



Influence of Light, 59 

that sunlight by being transmitted through the eye 
and propagated by the manifold ramifications of the 
nervous system throughout the body, enhances the 
work of building bone, muscle, blood and brain, as 
well as that of force production ; and hence it ranks 
as one of the most essential stimulants in our en- 
vironment. Indeed it is well known to every intel- 
ligent practitioner of medicine that every vital act 
is intimately dependent on the constant and undi- 
minished influence of the nervous system, and that 
the nutrition of any organ in the body is readily 
disturbed if the integrity of the latter becomes im- 
paired. And if we take this view of its mode of 
action it appears very clear to us why it is that per- 
sons who are deprived, and those who studiously 
deprive themselves of sunlight, become weak, pale 
and debilitated. Why palpitation of the heart 
so frequently occurs, and why the least exertion 
renders them short of breath. Why they appear 
prematurely old, why they manifest but little recu- 
perative power when laid low by disease, and why 
nervous diseases, such as asthma, epilepsy and in- 
sanity, are often aggravated by darkness and ameli- 
orated under the influence of sunlight, A similar 
train of consequences would inevitably follow in 
other directions were any of the other essential 
stimulants in our environment withdrawn. For 
sunlight is no less a stimulant to the body, than is 



60 Consumption. 

our food or our air, and yet how many persons are 
there who take every precaution to shut the light 
out of their dwellings, for the simple reason that it 
fades the carpets and furniture, without knowing, at 
the same time that they are barring out health and 
happiness. We can thus appreciate the importance 
of giving that class of persons whom we have under 
special consideration, a free and unstinted supply of 
sunlight. 



CHAPTER IX. 

INFLUENCE OF PHYSICAL EXERCISES. 

It is a universal law in living nature that constant 
moderate use of any organ in the animal body stimu- 
lates its growth and development. The blacksmith's 
arm and the dancer's calf are common examples of 
the effects of such exercise on certain groups of 
muscles. The lungs although not muscular organs, 
are likewise subject to this same law, and if, as I 
think it can be shown, that these structures can be 
developed and invigorated under the influences of 
physical exercise, then it becomes at once apparent 
that the latter is a most important lever in combat- 
ing the tendency to pulmonary consumption ; for 
from what has already been said, it is evident that, 
if in any way the condition of these organs can be 
improved, or maintained at or near a healthy stand- 
ard, the danger toward such a disease is altogether 
averted. 

The lungs, as we have already remarked in previ- 
ous pages, are the instruments which expose the 

61 



62 Consumption. 

blood to the air, and give to it the necessary amount 
of oxygen to carry on the movements of the animal 
machine. Now muscles in motion, or during phy- 
sical exercise, require more blood than they do in a 
state of rest, accordingly the heart, in order to meet 
this greater demand, accelerates its speed and dis- 
tributes more blood throughout the blood-vessels of 
the body, but while it throws out more blood to the 
muscles, it also receives more in turn, and sends a 
greater quantity to the lungs for the purpose of 
oxygenation, or of being exposed to pure atmos- 
pheric air, and this very naturally entails more labor 
on the latter organs. It thus becomes plain how it 
is that general muscular exercise of the body can in 
an indirect manner improve the structure and func- 
tions of the lungs — how in this manner it is possible 
to make them stronger, increase their capacity, and 
enable them to resist the encroachment of disease. 
The investigations of Dr. Edward Smith clearly 
show that physical exercise vastly increases the ac- 
tivity of the lungs. He found that the lungs exhale 
a much greater quantity of carbonic acid in bodily 
motion than in bodily rest. Now the amount of 
carbonic acid produced in the body under such cir- 
cumstances, is a measure of the amount of work 
which is performed both by the muscles and lungs ; 
for the former generate this substance during exer- 
cise, and the latter excrete it, and if more is generated 



Influence of Physical Exercises, 6 



3 



by the muscles and eliminated by the lungs during 
a given time in exercise than at rest it is direct 
proof that their action is enhanced under the former 
condition. 

Dr. Smith in his experiments exhaled the follow- 
ing amounts of carbonic acid in various conditions 
of the body : * 

Carbonic Acid 

exhaled per minute 

in grains. 

During sleep ...... 4.99 

Lying down and almost asleep (average of 

three observations) . . . . 5.91 

Walking at the rate of 2 miles per hour . 18.10 

Walking at the rate of 3 miles per hour . 25.83 

Working at the treadmill, ascending at the 
rate of 28.65 feet per minute (average 
of three observations) . . . 44-97 

That the interests of the lungs and muscles are very 
closely associated is markedly shown in those who 
are suffering from disease of the lungs, especially in 
the incipiency of such diseases. The muscular sys- 
tem of those persons at such a time is in a compara- 
tive state of health, yet they are almost wholly un- 
able to perform any severe muscular labor: an in- 
capacity, which is out of all proportion to the health- 
fulness of their muscles, and altogether inexplicable, 

* From Pavy's Food and Dietetics, p. 107. 



6\ Consumption. 

if we leave out of consideration the deterioration 
which is taking place in the lungs. 

Now while it is true that the lungs become in- 
vigorated and develop under the influence of general 
muscular exercise, it is also true that this process can 
in a great measure be aided and enhanced by special 
exercise of the muscles which surround the chest 
walls, and in order to make this intelligible it is ne- 
cessary to enter into a brief description of the prin- 
cipal anatomical structures which participate in this 
operation. 

The walls of the chest, in the first place, are com- 
posed of curved bones, called ribs, which are loosely 
attached to the spinal column behind, and flexibly 
to the breast-bone in front. When the chest is at 
rest the ribs point obliquely outward and downward. 
In the second place every rib is bound to its neigh- 
bor by means of intervening muscles called inter- 
costals, but beside these intercostal muscles the first 
and second ribs have three extra muscles, called 
the scaleni, which run diagonally from their front 
ends up and back to the spinal column in the neck, 
where they are inserted. And in the third place 
the contents of the chest are separated from those 
of the abdomen by a thin broad muscle which 
is attached along the whole lower border of the 
chest walls, and which, in a state of quietude, 
forms an arched floor to the chest, with its con- 



Influence of Physical Exercises. 6£ 

vexity looking upwards and its concavity down- 
wards. 

Now all these muscles are partly under the con- 
trol of the will, and during inspiration or inhalation 
the first and second ribs are elevated and fixed by 
the scaleni muscles, while contraction of the inter- 
costal muscles moves all the ribs in an upward direc- 
tion, and naturally from their peculiar oblique posi- 
tion such a tendency will cause them to rotate out- 
wards at the same time, thus expanding the circum- 
ference of the cavity of the chest in a marked degree. 
But while this lateral widening is taking place, the 
arched floor — the diaphragm — also contracts, and 
assumes a flat and horizontal position, thus enlarg- 
ing the cavity of the chest, in a vertical or perpen- 
dicular direction. Such a harmonious action of the 
muscles which surround the chest evidently pro- 
duces a sort of vacuum within the cavity of the lat- 
ter, and the air in the process of equalizing the pres- 
sure between the inside and outside rushes in and 
expands the lungs. This constitutes an act of in- 
spiration. In expiration or exhalation all the mus- 
cles of the chest become relaxed and the elastic 
fibres of the lung-tissue force the air back again. 

Again, we must not leave out of consideration the 
broad fan-shaped pectoral muscles which arise from 
the front of the chest on each side and are inserted 
into the upper portion of the arm, for whenever the 



66 Consumption. 

arms are extended upwards or backwards simul- 
taneously with inspiration, the latter act is greatly 
facilitated. 

That muscular exercise, both general and special, 
increases this volume of the lungs is well verified by 
'direct and positive evidence. The ordinary capacity 
of the respiratory organs is about 200 cubic inches, 
but in those who undergo regular and persistent ex- 
ercise, it is frequently the case that their Capacity 
is improved to the extent of 50 cubic inches more, 
and post mortem examinations show that such lungs 
also increase in length and breadth. 

Walking, running, rowing, and swimming throw a 
large number of muscles into action, and for this 
reason constitute excellent modes of general bodily 
exercise. While engaged in such practice no con- 
striction should be allowed around any part of the 
body, for the lungs, heart, and blood-vessels must 
have free and uninterrupted play in their accelera- 
ted functions. Particular caution is necessary not 
to carry such exercise to excess, for this may lead to 
a rupture of the large blood-vessels and to hemor- 
rhage from the lungs. If, during such exercise there 
arise any great shortness of breath, or pain in the 
chest, it is an indication that the lungs and heart are 
worked to their extreme limit, and must be taken 
as a fair warning to desist, or at least to slacken the 
speed. At first all exercise should to be very mod- 



Influence of Physical Exercises. 67 

crate, and gradually intensified with the develop- 
ment of the strength of the muscles, until the latter 
are forced to their utmost physiological capacity. 

To enlarge the breathing volume of the lungs by 
special physical exercise, the body must be erect and 
in fresh air, hands meet in front and gradually move 
backwards as far as possible simultaneous with a 
deep inspiration, and then forward again with each 
expiration. It should be done several times during 
each day, and its duration be limited by the setting 
in of fatigue. This operation can be rendered more 
effective by the use of dumb-bells or Indian clubs. 

It is of the highest importance to keep in mind 
the fact that whatever the mode of physical exercise 
may be, it must not be compulsory, but must be 
performed without effort and, as it were, without 
consciousness. It is for this reason that hunting, 
fishing, bowling, dancing, etc., if not carried to abuse, 
are conducive to good health and good spirits, for 
here the excitement is so great and so charming that 
it makes the individual forgetful of the amount of 
muscular labor which he performs. 

I would indeed treat this part of my subject in a 
very imperfect manner were I to omit saying some- 
thing in regard to the influence of the exercise of 
the voice on the lungs. Contrary to the current 
opinion among the lay classes, I believe that sing- 
ing, speaking, etc., when carried on in accordance 



68 Consumption. 

with the laws of health, are most potent factors in 
strengthening the respiratory organs, and in warding 
r off the tendency to pulmonary consumption. The 
deep inspirations and prolonged expirations which 
are necessary to good singing and to good speaking, 
is a process which in turn gently expands and 
empties the lungs in a very effectual way, and which 
can have no other effect than that of promoting the 
strength and developing the capacity of these organs, 
if the physiological law is true, that exercise of an 
organ adds to its vigor. It is only when such prac- 
tice is carried to excess, when the vocal organs are 
strained beyond their endurance, that baneful re- 
sults follow. A rule which should be heeded is, 
never to sing or speak after the least fatigue or pain 
is experienced in the throat or lungs. By constant 
and moderate exercise, however, such weakness can 
in time be readily overcome. 



CHAPTER X. 

INFLUENCE OF DISEASE, ETC. 

FROM what has been said it may be taken for 
granted that any cause which depresses or under- 
mines the vitality of the body also tends to pave the 
way for the development of consumption, especially 
in those who are predisposed to it ; hence it is a 
matter of the greatest moment to such persons to 
carefully guard this avenue against the invasion of 
this dreadful enemy. 

Among the many causes of consumption " colds " 
occupy a very prominent rank. This is not due to 
any malignant character of these troubles, for they 
are just the reverse, but because they are usually 
regarded as harmless and in consequence of this are 
neglected. Without great care " colds " are readily 
acquired in any locality, especially when the body is 
compelled to undergo sudden and extreme changes 
of temperature, which generally lead to congestion 
and inflammation of some portion of the breathing 
surface. In most instances the first attack of cold 

69 



70 Consumption. 

is slight and transient, perhaps confined to the nose 
and throat, (the throat in scrofulous subjects is ex- 
tremely liable to inflammation), and disappears of 
its own accord in a very few days. But, however, 
slight it may be, its existence is conclusive evidence 
that the resistance of the invaded tract is impaired 
to a certain extent, and is less able to ward off sub- 
sequenc attacks ; and as soon as the proper opportu- 
nity presents itself a second onslaught will be made 
more readily and more severely, and very probably 
extend over a larger territory than the first. In 
this manner the normal resistance of this surface 
becomes reduced from time to time, and the con- 
gestion and inflammation spread further until at last 
the windpipe, bronchial tubes, and the lungs them- 
selves become involved in the destructive process. 
Such a process occurring in a person who is in the 
least prone to consumption, is an extremely danger- 
ous one, and is liable to be fanned into activity 
under the least provocation at any time. 

Hence it is of supreme moment that the body 
should be amply protected against " colds " by 
means of suitable clothing, and other comfortable 
hygienic surroundings. Heavy clothing and con- 
finement in warm rooms, however, will not effect 
this, but efforts must be made to adapt the body to 
the prevailing climate by frequent physical exercise 
in the open air. 



Influence of Disease, Etc. Jl 

Fever and ague, or what is generally known as 
chills and fever, exerts a most pernicious influence 
on all those who are predisposed to pulmonary con- 
sumption. In the chapter on the influence of soil- 
moisture I have referred to the possibility of pro- 
ducing chills and fever by fluctuations in the at- 
mospheric temperature. When the cold drives the 
blood from the skin into the interior of the body, it 
is very natural that those organs which are the most 
vascular, or in other words those which contain the 
largest number of blood-vessels, receive the greatest 
quantity of blood. Now the lungs are, so to speak, 
one dense mass of blood-vessels, and in the chilly 
stage become engorged in proportion to the severity 
of the attack, and remain so until it has passed off 
and the sweating stage follows. The common ex- 
perience of those who have been subject to this dis- 
ease, attests the fact of their inability to perform any 
severe physical labor, even after the attack of ague 
has subsided, on account of the great shortness of 
breath ; which is wholly due to the great engorge- 
ment of blood in the lungs. It is needless to say 
that such a process puts the lungs to a severe test, 
and, if continued, will eventually lead to disorgani- 
zation of these structures, and must certainly de- 
velop any latent tendency to consumption that may 
exist. 

Persons of a scrofulous temperament are specially 



72 Consumption. 

susceptible to the cause which brings on fever and 
ague, for we have already learned that they are consti- 
tutionally weak ; that their power of resistance to such 
an aggressive force is diminished ; and therefore they 
should never inhabit a low damp soil, nor a locality 
subject to great and sudden changes of temperature, 
and always avoid sleeping on ground or cellar 
"floors. Almost any climate, no matter how equable 
in temperature, or however free from dampness, 
will at times, as in the fall of the year for example, 
when the days are uncomfortably hot, and the nights 
excessively cold, produce a feeling of chilliness, al- 
ternating with flashes of heat, pain in the limbs and 
back, all of which symptoms indicate something like 
incipient fever and ague. This feeling of chilliness, 
or disturbance of the bodily temperature, is very 
characteristic in scrofulous individuals, and if the 
disorder does not manifest itself in a well defined 
paroxysm of fever and ague, half a grain of quinia, 
once or twice a day, will in most cases suffice to tone 
up the body to its usual standard. Not only is there 
no harm done by such small doses of quinia as is 
generally supposed, but it imparts life and vigor to 
every function in the body. When the perturba- 
tion amounts to a well-marked chill and fever, 
more definite and acurate treatment is necessary 
than I can lay down here, and the aid of a phy- 
sician should at once be called in, who is generally 



Influence of Disease, Etc. 73 

able to terminate the trouble in a short time. 

INJURIOUS OCCUPATIONS. 

Certain occupations like stone cutting, coal 
mining, scissors grinding, steel polishing, &c, are 
very injurious to the respiratory organs, on account 
of the small particles of dust which are constantly 
given off, are diffused, inhaled, and cause irritation. 
Persons who have inherited or acquired a consump- 
tive tendency should never engage in any of these. 



CHAPTER XL 

INFLUENCE OF DIGESTION. 

I have already alluded to the potent influence 
which food exerts in keeping up the standard of 
health, and in this way aids in warding off the de- 
velopment of any latent tendency to consumption ; 
but we have also learned that the stomach shares 
the common weakness of the whole body in scrofu- 
lous persons, or in those who are predisposed to con- 
sumption. Indeed, it is a fact well attested by those 
who have an extended experience in the treatment 
of consumption, that in many instances derange- 
ment of the digestive organs is a sure prelude to the 
battle which will take place, sooner or later, in the 
lungs ; hence, however essential the relation which 
the food sustains to the body may be, it is of far 
greater importance to maintain the integrity and 
healthiness of the digestive organs. For, after all, 
food can only serve its useful purposes in the body 
after it has undergone a thorough preparation for 
absorption by the blood, and this is impossible if the 

74 



Influence of Digestion. 75 

stomach and bowels are impaired in their functions. 

Now digestion is the process which, by various 
mechanical and chemical operations, prepares the 
food for absorption by the blood, for the latter fluid 
is not capable of taking up anything from the stom- 
ach or bowels, unless it is in a fine state of division 
or attenuation. Of the mechanical contrivances, 
chewing comes first, the importance of which can 
hardly be overrated. All animal and vegetable al- 
bumen, or our nitrogenous food, must here be reduced 
to a fine pulp, so as to be readily acted on by the 
gastric juice after being swallowed. As soon as the 
food enters the stomach it is subjected to a series of 
wave-like contractions, which impart to the whole 
mass a sort of rotary or churning motion, while at the 
same time it is exposed to the chemical action of the 
gastric juice which oozes out of the walls of the 
stomach. After the mass leaves the stomach the 
same process is continued by the upper portion of 
the bowels, aided by their own secretion and that of 
the liver, until finally the whole mass has undergone 
a complete modification and the nutritive part is ex- 
tracted and absorbed. 

Of all the animal foods, such as beef, mutton, 
veal, lamb, pork, venison, poultry, game, wild-fowl, 
fish and shell-fish ; beef and mutton are the most 
nutritive * and digestible, especially the former. 

* I use the term nutritive food as an equivalent to constructive 
food, or that which builds the bodily frame. 



; "5 Consumption. 

Although beef is perhaps less readily digested than 
mutton, yet these two kinds of meat are vastly 
superior in point of digestive and nutritive value 
to veal and lamb. Hence the two latter must be 
studiously avoided in all forms of dyspepsia, and 
in weakness of the stomach. Pork is one of the 
most indigestible of meats, while venison is of com- 
parative easy digestion. The flesh of the fowl and 
turkey is tender, delicate in flavor, and is better ' 
adapted for digestion than that of ducks and geese ; 
but the flesh of game possesses superior nutritive 
properties to that of poultry, and is also of more 
easy digestion. Fishes are not as nourishing as the 
flesh of quadrupeds and birds, although they may be 
advantageously employed where the digestive power 
is weak and inefficient. Of all the shell-fish, oys- 
ters are the most nutritive, in fact, their value as 
such is very great. Contrary to the usual custom 
of heating or stewing oysters, they are of the great- 
est service when taken in a raw state. Exposure to 
heat coagulates the albumen, and thus in a great 
measure impairs their digestibility. 

Essence or extract of beef comprises the elements 
of nitrogenous food, and is a most serviceable mode 
of sustaining strength and failing vitality. Eggs 
consist of nitrogenous, fatty and inorganic matter, 
hence they are capable of serving the body in the 
double capacity of furnishing building material, as 



Influence of Digestion. JJ 

well as that of supplying moving force. Raw or 
lightly heated eggs are more readily digested than if 
boiled hard. 

Milk can be looked upon as being the ideal food 
for mankind, especially in the early stage of life. 
Milk, like eggs, consists of nitrogenous, non-nitrogen- 
ous, and inorganic material, and so posseses all the 
elements which are essential to develop the animal 
body. 

The vegetable alimentary substances which con- 
sist of the cerealia, such as wheat, oats, barley, rye, 
rice, etc., and the leguminosae, such as peas, beans, 
lentils, etc., are rich in nitrogenous and non-nitro- 
genous matter, hence their great value as articles of 
diet. 

The non-nitrogenous foods, like fat, sugar, starch, 
etc., will now occupy our attention in their relation 
to digestion, especially since their preparation pre- 
vious to their introduction into the blood-current is 
altogether different from that of the albuminous 
foods. To healthy digestion it is essential that these 
articles of diet be retained in the mouth until they 
are completely moistened with saliva ; for if they 
are deprived of the chemical change which is brought 
about by this fluid, their future value to the body 
is unquestionably limited. In the stomach these 
foods undergo very little or no change, but directly 
after leaving this organ they are brought in contact 



78 Consumption. 

with the secretion of the pancreas, or sweet-bread, 
which is the large salivary gland of the abdomen, 
and is to all intents a duplicate of the salivary glands 
of the mouth. But in those who are predisposed 
to consumption, this gland, as we have already seen, 
is very often weak and inefficient in the discharge 
of its duty, and if the fatty, starchy, or sugary food 
be swallowed without being duly mixed with saliva, 
under such circumstances they remain undigested, 
and beside -being a total loss to the body as force- 
producers, they cause acidity and flatulence, and 
are very apt to produce further irritation in the 
stomach and bowels. Inasmuch as this kind of 
food is of such vast importance to the integrity of 
the bodily functions, great care and vigilance ought 
to be exercised in its thorough mastication. There 
can be no doubt that many troubles in the digestive 
organs arise simply by a neglect of such a simple 
precaution. A tendency to sourness of the stomach 
after meals, under such circumstances can frequently 
be corrected or counteracted by drinking half a 
tumblerful of milk with a tablespoonful of lime- 
water before each meal. 

Drinking while eating, if not carried to excess, 
exerts a favorable influence on digestion. It hastens 
dissolution and absorption of the food. 

During eating as well as afterwards for some time, 
the mind and body ought to enjoy perfect repose. 



Influence of Digestion, 79 

Any exercise of the mental functions, be it in dis- 
tress or in work, will in proportion to its intensity, 
attract that nerve force away from the stomach 
which is necessary for digestion. Therefore in order 
to restrain the mind from what may be termed in-: 
voluntary excursions at such times, meals should be 
taken in the company of pleasant and agreeable 
friends, with whom a light and frivolous conver- 
sation may be carried on without injury. The same 
freedom of both body and mind should be strictly 
adhered to after meals until digestion is completed. 
Many confirmed dyspeptics, who are suffering from 
nervousness, and from pain, tenderness and fulness 
over the whole, or back part, of the head after a lit- 
tle unusual mental application, can without much 
difficulty trace the origin of their trouble to a vio- 
lation of this law of health ; to too great mental 
activity during, or directly after meals. 

But however, excellent the digestive organs may 
be in point of capacity or efficiency, they will in- 
evitably succumb to disorder unless they receive the 
constant attention and cooperation of the cook. 
This personage ought to possess a complete knowl- 
edge of the art and science of cooking, so as to be 
abundantly able to promote and enhance the diges- 
tibility of each article of food as it passes through 
her hands. She ought fully to understand, that 
variety of food, as well as embellishment of the same 



80 Consumption 

when served on the table, is not only pleasing to the 
eye, but is also tempting to the appetite and aids diges- 
tion. With great truth may it be said that the cook 
holds the destiny of many a stomach in her own 
hand, and thus in a measure controls the lives of 
many millions. Now when we reflect upon the 
abject ignorance which is displayed in many homes 
on this pre-eminently important subject, we are 
driven to the unavoidable conclusion that the evil 
committed in this direction far outweighs the good. 



CHAPTEk XII. 

INFLUENCE OF INFANT DIET. 

VERY little proof is necessary to establish the fact 
that the safety and durability of a dwelling depend 
in a large measure upon the security and stability 
of its foundation. Precisely the same is true of the 
human body, for the conditions which surround it 
in its infancy determine, to a great extent, the 
weakness or robustness of the adult. This is the 
most critical portion of life, for here the whole 
frame develops with greater rapidity than during 
any other period of its existence, and the slightest 
interruption of this process manifests itself in dis- 
ease. Therefore it devolves upon parents, and es- 
pecially upon mothers, to allow nothing whatever to 
interfere with the w r ork of laying the foundation 
which is to shape the physical as well as the mental 
destiny of their offspring, and not only strive to dis- 
charge this sacred responsibility with conscientious- 
ness, but also with intelligence. This advice applies 
with emphasis to that large class of persons for 

Sr 



82 Consumption. 

whose benefit these pages are written, for they must 
remember that above all others they have an inher- 
ent tendency to transmit a weakness to their child- 
ren which oftentimes, with due knowledge and atten- 
tion can be entirely eliminated. 

Now in order to rear such a complex and delicate 
structure as that of an infant's body, it is obvious 
that the food of the child must comprise all the es- 
sential elements of its structure ; hence the question 
of diet constitutes an all-absorbing problem in the 
history of an infant's life. But here nature which 
rises higher than the wisdom of man, steps in and 
embodies these necessary ingredients in the form of 
milk, which is the only food that is adapted to the' 
infant's stomach, to which mothers and nurses 
ought strictly and unflinchingly to adhere until the 
early teeth have fully sprouted. The truth of the 
above statement, that milk is the only suitable food 
for infants, is shown by the disastrous consequences, 
which have so far attended, and ever will attend, all 
efforts to supplant milk with artificial diet. Upon 
the subject of infant feeding in relation to consump- 
tion, or to the consumptive predisposition, Prof. 
Loomis * utters the following decided language : 
" There has come to be an opinion in the profession 
that phthisis (consumption) is certainly to develop 

*" Lectures on Diseases of the Respiratory Organs, Heart and 
Kidneys," page 229. 



Influence of Inflant Diet. 83 

sooner or later in those who have a strong heredi- 
tary phthisical predisposition ; that because the 
father or mother, or brother or sister has died of 
phthisis, that other members of the same family will 
have the disease ; but the development of the dis- 
ease in every such case depends more upon the an- 
tecedent hygienic influences under which the child- 
hood or adult life has been passed, than upon the 
hereditary phthisical predisposition. These predis- 
posing anti-hygienic influences embrace the import- 
ant problem of infantile diet. 

" How few infants are properly fed ! How few 
mothers — especially among the wealthier classes — 
are in a condition to properly nourish their own off- 
spring ! The habit which prevails of feeding chil- 
dren until they are one, two or even three years of 
age, upon barley water, paps, sweetmeats and indi- 
gestible articles of diet, has a most pernicious in- 
fluence upon the future physical development of the 
child, and if at the very entrance upon adult life of 
such children, phthisis is not induced by some local 
cause, it will be an exception to the rule." 

When the milk of the mother becomes contami- 
nated in consequence of disease, or fails on account 
of the mother's death, and a wet nurse cannot be 
procured, cow's milk comes next in point of useful- 
ness ; but however good and fresh the latter may 
be, it cannot, by any means, fill the place of moth- 



84 Consumption. 

er's milk. Cow's milk for this purpose must be per- 
fectly fresh, and is prepared by mixing one part of 
pure water to two parts of milk with the addition of 
a little sugar, and given to the infant at a luke warm 
temperature. It is very important that the feeding 
bottle should be kept clean. If the milk is vomited 
or passed from the bowels in the form of curds some 
lime water should be added. Lime, water, besides 
proving very efficacious in many of the digestive de- 
rangements to which infants are liable, also fur- 
nishes one of the principal ingredients in the struct- 
ure of bone, as well as in that of the teeth. 

Pregnant women, and mothers as long as they 
nurse their infants, are able to contribute much to 
the healthfulness of their offspring by partaking of 
the most nourishing food, such as meats, oysters, 
eggs, milk, etc., taking plenty of gentle exercise, 
and living out of doors as much as possible. 



CHAPTER XIII. 

INFLUENCE OF COD-LIVER OIL, FAT, BUTTER AND 
ALCOHOL. 

I CANNOT close this interesting subject without 
making some special remarks on the great value of 
force-producing foods in supplying the energy which 
is stealthily and gradually wasted in those who are 
predisposed to consumption. By referring to Chap- 
ter IV y the reader will see by glancing at the table 
of the comparative value of foods, that cod-liver 
oil occupies a higher position as a force producer 
than beef-fat or butter. Any substance which holds 
as large a store of force as cod-liver oil does, must cer- 
tainly be considered a very valuable agent in restoring 
the failing energy of the body on theoretic grounds 
alone, and experience also proves that there is no 
single remedy superior to it in the prevention of 
this disease. In langour, a disposition to muscular 
weakness, dryness of the skin, loss of weight when 
associated with cough and tenderness in the chest, 
tickling in the throat, the good effects of cod-liver 
oil are particularly marked. Scrofulous persons 

85 



86~ Consumption. 

would fare better, at any rate, if they would take 
the oil every spring and fall in order to protect them- 
selves against the sudden changes of temperature 
incident in these seasons. Whenever the stomach 
does not tolerate the raw oil, an emulsion of the 
same may be substituted with advantage. It must 
always be taken on a full stomach, or directly after 
meals, and if it is not digested with facility, it must 
be retained in the mouth for a short time to be 
mixed with the saliva before swallowing. 

Nearly all scrofulous persons possess a natural 
dislike for all greasy articles of food, and they almost 
invariably, and at times unconsciously, divest their 
meat of fat before they eat it. Now such persons 
above all others require the force which they waste 
in this manner, and must endeavor to conquer this 
pernicious habit by eating a little fat at a time, 
chew it well, and mix it thoroughly with the saliva. 
Butter is a very prominent force-producing food, 
and although it does not contain as much latent 
energy as cod-liver oil or beef-fat, it must yet be re- 
garded as having a very important bearing to the 
subject under discussion, because, in the first place, 
it is so universally employed by nearly all civil- 
ized communities ; and, in the second place, because 
it is very palatable to the large majority of scrofu- 
lous people. Such persons while, as a rule, they 
have strong repugnance to fat, are abundantly able 



Influence of Cod-Liver Oil y Etc. 87 

to consume this article without any inconvenience, 
and for these reasons they ought to supply it to 
their bodies in unstinted quantities. 

It is eminently meet that I should say a few words 
concerning the important relation which alcohol 
sustains to the body in a depressed and enervated 
condition. The latest investigations on alcohol 
bring the conviction to every intelligent and im- 
partial mind, whatever prepossessions may exist, 
that if used in small quantities, and under con- 
ditions of actual necessity, it acts not only as a food 
by imparting energy to the body, but also materially 
aids the process of digestion, and so confers a power 
and a benefit, the value of which cannot be over- 
estimated. 

Alcohol is a double-edged instrument, powerful 
for great good or for great evil, and therefore re- 
quires to be used cautiously and carefully ; but 
happily the line which marks its good from its bad 
effects — its food action from its intoxicating action — 
is so sharply defined that it cannot be mistaken. 
For as long as the body is capable of burning up 
or oxidizing all the alcohol taken in, no harmful 
effects do or can manifest themselves, but as soon 
as this limit is overstepped, unmistakable evidences 
of poisoning display themselves, prominent among 
which are flushing or sweating of the face, fulness 
and heat in the head, together with increased action 



88 Consumption. 

of the kidneys. Therefore whenever these symptoms 
appear, its further use must at once be discontinued. 
The action of alcohol on the walls of the stomach 
requires to be brought into notice here, and we shall 
find that the same rule which governs its action in 
other parts of the body holds equally true here, viz : 
that small doses produce healthful, and large doses 
harmful effects. It is hardly possible that the total- 
abstinence people could have invented the unfound- 
ed notion that alcohol on being taken into the 
stomach, in whatever quantity, coagulates the al- 
bumen of that organ, and so destroys its function of 
digestion ; since it is a fact comparatively long 
known that the action of alcohol on the stomach in 
small doses is similar to that of our ordinary food. 
When a small quantity of alcohol comes in contact ' 
with the pale, gastric, mucous membrane, the blood- 
vessels dilate, the surface attains a rosy hue, and its 
glands secrete a profuse quantity of gastric juice, in 
precisely the same manner as in the case of food. 
But the condition of the stomach becomes wholly 
changed after the introduction of larger quantities 
of alcohol. The rosy color of the mucous membrane 
fades and the secretion of gastric juice is suspended, 
and in this condition of things only does the albumen 
of the stomach become coagulated. This has been 
well observed through an opening, or fistula, into 
the stomach. 



CHAPTER XIV. 

CONCLUSION. 

In summing up the considerations in the preced- 
ing pages, I think it appears conclusive that con- 
sumption, or the tendency to it which exists in many 
individuals, is essentially a premature dissipation of 
the force and matter of the body, and that improper 
food, bad air, deprivation of sunlight, poor clothing, 
want of physical exercise, disease, imperfect diges- 
tion, all accelerate this process of waste. Therefore 
in all our efforts at prevention the path of duty lies 
straight before us, and consists in conserving these 
two elements of the body by laying a good founda- 
tion in infancy, by preserving the organs of diges- 
tion, by eating an abundance of rich and nutritious 
food, such as fat, butter, meat, milk, eggs, etc., by 
breathing pure air, by living on dry soil, by wearing 
warm and comfortable clothing, by taking plenty of 
physical exercise, and by avoiding disease and in- 
jurious occupations. 

Upper Lehigh, Pa., 
May 30, 1879. 

80 



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i2mo. Household edition, ..... $1.50 

•' In Bayard Taylor's happiest vein." — Buffalo Express. 
" By far the best novel of the season." — Cleveland Leader. 

V. Beauty and the Beast and Tales of Home, nmo, 
cloth, $.75. Household edition, . . . . $1 50 



Bayard Taylor's Complete Works. 

The Complete Works of Bayard Taylor. In sixteen 
volumes. Household edition, .... $24.00 

The Travels, separate, eleven volumes. Household edi- 
tion, $16.50 

The Novels, separate, five volumes, boards. Cedarcroft 
edition, $6.25 






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